此乃阳明胃经,因 炙所致,或兼思虑暴怒,痰随火行,流至于唇,而结如豆大。若蚕
茧突
肿,坚硬作痛,饮食妨碍,或破流血,久则难治。若初起无内症,用麻子大艾炷灸三壮,贴
蟾酥膏盖之,日久渐愈。若有内症,作渴,早服八味丸,午服甘露饮。日久流血不止,形弱
面黑,虚热痰生,腮颧红而口渴甚者,难治。
清凉甘露饮
犀角 茵陈 石斛 枳壳 麦冬 生地 黄芩 柴胡 知母 生甘草 枇杷叶(各一钱)
灯草 淡竹叶
凡喉症至五日即重,如三日前,症虽重尚未成脓,药能消散。若至五六日,患处多成脓
,随
便穿破,后必烂成一窠而难愈。烂处须用口疳药,多用龙骨、珍珠。凡伤寒后患连珠鹅及喉
闭者不治。其症喉项强硬,目睛上视,故多不治。
凡喉症非急症,一二日未必发寒热,病尚轻缓,若至第三日发寒热,症必加重。须问其
大小
便通利否,如二便利,症虽加,不过浮火上攻,服解毒消风清火之剂,即愈。若二便不通利
,乃内有实火,非用降火解毒重剂,及通二便之药。火从何而泄,病从何而解。亦即问其头
可痛否,如头痛则兼伤寒,难治。
凡喉症,非俟其大便出后,方可望痊。若大便秘结,未可轻许其无碍。
凡喉症初起,大便秘结,宜用大黄、玄明粉通之,则火自降而易痊,即降火解毒之剂内
,去
前胡,加大黄、玄明粉行之。若至五六日久不食,而大便秘,用之即刻毙。盖病久胃气已虚
,岂宜再用硝黄?只宜用蜜导法,此秘诀也。凡患喉症,无痰者不治。
凡患喉症须吹药四五管,方可出痰,三次可以全愈。其出痰,初用必要多用金丹为妙,
必直对喉咙中重重吹之,即提出吹管,恐痰即呕出。
凡喉症初起一二日,用碧丹渐加金丹。势甚者,金丹为君,或纯用金丹,方能吊出顽痰
,出痰非金丹不可。
凡喉症,至胸前红肿,此系肺痈。用蜜调,加百药煎服之。凡喉中无形而红痛者,用灯
草灰吹之。
凡妇人喉中肿痛,有因经闭,致火上攻而患者。宜内服通经药,经通则喉自愈。
凡喉症凶者,面发肿,白亮无光彩,脉沉微无力,是神气外泄无阳之症,断不可治。
若面发红肿,脉来洪大有力,症虽重,是有元气火盛,治之易痊。
凡腮内口内肿烂,用箸缠丝绵,蘸水轻搅患处。痛者,用药必愈;如不痛者,即死肉,
多难治。
凡舌肿胀满口,吐舌在外,难以纳药者,用僵蚕、皂角,俱研极细末,等分和匀少许,
吹入
鼻中,牙关自开,痰涎自出。然后用绵缠竹箸蘸甘草汤,润其唇口,再加用四味,口疳药多
加顶高冰片,频吹自愈。
凡吹药,不但肿碎患处,并四围好肉上亦要吹之,方不散开,且易愈也。至若舌上干甚
,难
于吹药,或用蜜润,或用汤水湿之,药可吹上。喉内吹法,须用气和平,用管周遍为妙。
凡舌肿大,用生黄柏末加冰片敷之,或出血用炒柏加冰片敷之。
凡 舌、喉痈,如大便闭,应药内加玄明粉、大黄。小便不利,加六一散,服之甚效,
一法也。
凡用碧丹,症凶者,冰片多于甘草;将愈,甘草多于冰片。
凡患牙痈,牙根红肿,但牙关不闭,口能开阖。若患牙咬,牙根红肿,胀肉突出。
凡牙关紧闭,口不能开者,先用金、碧二丹吹入牙根。外用黄熟香削成凿子样,渐挨进
牙缝,则牙关渐开,即将金丹吹入患处。
凡吹喉症,或欲出痰,加皂角少许。
凡初起吹药,须令患者低头,溜出痰涎唾。
凡喉痈及单双鹅,率用碧丹。其他重症,金丹、碧丹兼用,须知先后多寡,初起碧九分
金一
分,吹至五管,改用碧八金二,再次用碧丹七分金丹三分。如症重,碧、金各半,用至三五
次后,痰涎必上壅,然后用金六碧四,将吹管直对喉中,重吹一吹,随手出管,即吊出痰,
此要诀也。若症极重,竟用金八分碧二分尤妙。
凡喉症先碎,先用长肉药吹之,后用碧丹以治之。
通经方(孕妇忌服)
当归 赤芍 广皮 川断(各一钱) 牛膝(一钱五分) 川芎(六分) 红花(七分) 甘草(五
分) 桔梗(一钱)
血热加大生地、丹皮,热极再加犀角。经久不行加苏木、五灵子、泽兰叶。腹痛加元胡
索、
桃仁。股痛加杜仲倍牛膝膏滋药,即蜜调青炭色,用龙脑、薄荷为君,玉丹为臣,川贝去心
为佐,灯草灰、百草霜、甘草、冰片为使。先将玉丹、百草霜研和后,入灯草灰再研,再入
薄荷、甘草、川贝,研极细,再入冰片,再研匀,蜜调服。喉痈喉菌,须时时噙咽。若症重
兼服三剂,及吹药。
这是阳明胃经,因炙烤(或辛辣炙煿食物)所致,或者兼有思虑过度、暴怒,痰随火气运行,流注到嘴唇,结聚如豆子大小。如果像蚕茧一样突起肿胀,坚硬且疼痛,妨碍饮食,或者破溃流血,时间久了就难以治疗。如果初起没有内症,用麻子大小的艾炷灸三壮,贴上蟾酥膏覆盖,日子久了会逐渐痊愈。如果有内症,感到口渴,早上服用八味丸,中午服用甘露饮。时间久了流血不止,形体虚弱面色发黑,虚热生痰,腮帮颧骨发红且口渴严重的,难治。
清凉甘露饮
犀角 茵陈 石斛 枳壳 麦冬 生地 黄芩 柴胡 知母 生甘草 枇杷叶(各一钱)
灯草 淡竹叶
凡是喉症到了第五天就会加重,如果在前三天,症状虽然重但尚未成脓,药物能够消散。如果到了五六天,患处多已成脓,随意穿破后,必定烂成一窟窿而难以愈合。腐烂处必须使用口疳药,多用龙骨、珍珠。凡是伤寒后患连珠鹅及喉闭的,无法治疗。其症状是喉咙颈部强硬,眼睛向上翻视,所以大多无法治疗。
凡是喉症不是急症,一两天未必出现寒热,病情尚轻缓,如果到了第三天出现寒热,症状必定加重。必须询问其大小便是否通利,如果二便通利,症状即使加重,也不过是浮火上攻,服用解毒消风清火的药剂,即可痊愈。如果二便不通利,那是内有实火,非要用降火解毒的重剂,以及通利二便的药物。火气从哪里排泄?病邪从哪里解除?也要询问头部是否疼痛,如果头痛则兼有伤寒,难治。
凡是喉症,不等到大便通畅排出,才可以希望痊愈。如果大便秘结,不可以轻易许诺无碍。
凡是喉症初起,大便秘结,宜用大黄、玄明粉通下,则火气自然下降而易于痊愈,即在降火解毒的药剂内,去掉前胡,加入大黄、玄明粉来行气通便。如果到了五六天久不进食,且大便秘结,使用大黄、玄明粉会立即致死。因为病久胃气已虚,哪里还能再用硝石、大黄?只宜用蜜导法,这是秘诀。凡是患喉症,没有痰的无法治疗。
凡是患喉症需要吹药四五管,才可以吐出痰涎,三次可以完全痊愈。其吐痰,初用必须多用金丹为妙,一定要直对喉咙中重重吹入,随即提出吹管,恐怕痰即被呕出。
凡是喉症初起一两天,用碧丹逐渐增加金丹。势头严重的,以金丹为主药,或者纯用金丹,才能吊出顽痰,吐痰非金丹不可。
凡是喉症,到了胸前红肿,这是肺痈。用蜂蜜调服,加百药煎服用。凡是喉中无形态改变而红痛的,用灯草灰吹入。
凡是妇人喉中肿痛,有因月经闭止,导致火气上攻而患病的。宜内服通经药,月经通畅则喉部自愈。
凡是喉症凶险的,面部浮肿,白色光亮无光彩,脉象沉微无力,这是神气外泄无阳的症状,绝对不可治疗。如果面部红肿,脉象洪大有力,症状虽重,是有元气且火盛,治疗容易痊愈。
凡是腮内口内肿烂,用筷子缠丝绵,蘸水轻轻搅动患处。疼痛的,用药必定痊愈;如果不疼痛的,就是死肉,大多难治。
凡是舌头肿胀满口,伸舌在外,难以纳入药物的,用僵蚕、皂角,都研成极细末,等分和匀少许,吹入鼻中,牙关自然张开,痰涎自然流出。然后用棉缠竹筷蘸甘草汤,润湿其唇口,再加用四味,口疳药多加顶高冰片,频繁吹入自愈。
凡是吹药,不但要吹碎肿烂的患处,四周好肉上也要吹之,才不散开,且容易痊愈。至于舌上干燥严重,难于吹药,或用蜂蜜润湿,或用汤水湿润,药才可吹上去。喉内吹法,须用气息平和,用管子周遍吹入为妙。
凡是舌肿大,用生黄柏末加冰片敷之,或者出血用炒黄柏加冰片敷之。
凡是舌痈、喉痈,如果大便闭结,应在药内加玄明粉、大黄。小便不利,加六一散,服用很有效,这是一法。
凡是使用碧丹,症状凶险的,冰片多于甘草;将愈时,甘草多于冰片。
凡是患牙痈,牙根红肿,但牙关不闭,口能开合。如果患牙咬(牙关紧闭),牙根红肿,胀肉突出。
凡是牙关紧闭,口不能开的,先用金、碧二丹吹入牙根。外用黄熟香削成凿子样,渐渐挨进牙缝,则牙关渐渐张开,即将金丹吹入患处。
凡是初起吹药,须令患者低头,溜出痰涎唾沫。
凡是喉痈及单双鹅(单乳蛾、双乳蛾),通常用碧丹。其他重症,金丹、碧丹兼用,须知先后多少,初起碧丹九分、金丹一分,吹至五管,改用碧丹八分、金丹二分,再次用碧丹七分、金丹三分。如果症状重,碧丹、金丹各半,用至三五次后,痰涎必会上壅,然后用金丹六分、碧丹四分,将吹管直对喉中,重吹一次,随手出管,即吊出痰,这是要诀。如果症状极重,竟用金丹八分、碧丹二分尤其妙。
凡是喉症先溃烂,先用长肉药吹之,后用碧丹来治疗它。
通经方(孕妇忌服)
当归 赤芍 广皮 川断(各一钱) 牛膝(一钱五分) 川芎(六分) 红花(七分) 甘草(五分) 桔梗(一钱)
血热加大生地、丹皮,热极再加犀角。经久不行加苏木、五灵子、泽兰叶。腹痛加元胡索、桃仁。股痛加杜仲倍牛膝膏滋药,即蜜调青炭色,用龙脑、薄荷为君,玉丹为臣,川贝去心为佐,灯草灰、百草霜、甘草、冰片为使。先将玉丹、百草霜研和后,入灯草灰再研,再入薄荷、甘草、川贝,研极细,再入冰片,再研匀,蜜调服。喉痈喉菌,须时时噙咽。如果症状重兼服三剂,及吹药。
This condition arises from the Yangming Stomach Meridian, caused by roasting (or consumption of spicy, roasted foods), or accompanied by excessive thinking and sudden anger. Phlegm follows the fire qi, flows to the lips, and knots like a bean. If it protrudes and swells like a silkworm cocoon, becoming hard and painful, hindering eating and drinking, or breaking and bleeding, it becomes difficult to treat if left for a long time. If there are no internal symptoms at the onset, moxibustion with three cones of mugwort the size of a hemp seed should be applied, followed by covering with Chan Su Paste (Toad Venom Plaster). It will gradually heal over time. If there are internal symptoms such as thirst, take Bawei Wan (Eight-Ingredient Pill) in the morning and Ganlu Yin (Sweet Dew Decoction) at noon. If bleeding persists for a long time, with emaciation, dark complexion, deficiency heat generating phlegm, redness of the cheeks and zygomatic bones, and severe thirst, it is difficult to treat.
Qingliang Ganlu Yin (Cooling Sweet Dew Decoction)
Xijiao (Rhinoceros Horn - *Note: Substitute with Water Buffalo Horn in modern practice*), Yinchenteng (Artemisiae Scopariae Herba), Shihu (Dendrobii Caulis), Zhike (Aurantii Fructus), Maidong (Ophiopogonis Radix), Shengdihuang (Rehmanniae Radix Recens), Huangqin (Scutellariae Radix), Chaihu (Bupleuri Radix), Zhimu (Anemarrhenae Rhizoma), Shenggancao (Glycyrrhizae Radix et Rhizoma Preparata), Pipaye (Loquat Leaf) (each 1 qian); Dengcao (Junci Medulla), Danzhuyeye (Bambusae Folium).
Generally, throat diseases become severe on the fifth day. If treated within the first three days, although the symptoms may be severe, suppuration has not yet formed, and medication can dissipate them. However, by the fifth or sixth day, the affected area often suppurates; once ruptured, it tends to ulcerate into a cavity that is difficult to heal. The ulcerated area requires Kougan Yao (Mouth Ulcer Medicine), using large amounts of Longgu (Fossilized Bones) and Zhenzhu (Pearl). Throat closure (Houbi) and Lianzhu E (String-of-Pearls Tonsillitis) occurring after Shanghan (Cold Damage) are incurable. The symptoms include stiffness of the throat and neck, upward deviation of the eyes, making prognosis poor.
Throat diseases are not always emergencies; chills and fever may not appear in the first one or two days, indicating a mild condition. If chills and fever appear on the third day, the condition must worsen. One must ask whether urination and defecation are unobstructed. If both are free, even if symptoms worsen, it is merely floating fire attacking upwards; taking detoxifying, wind-dispersing, and fire-clearing agents will lead to recovery. If urination and defecation are obstructed, this indicates excess fire internally. Heavy doses of fire-reducing and detoxifying agents, along with medicines to promote bowel and bladder movement, are required. How else can the fire be expelled? How else can the disease resolve? Also inquire about headache; if present, it suggests concurrent Shanghan, which is difficult to treat.
For throat diseases, recovery cannot be expected until stool is passed freely. If constipation exists, one cannot lightly assume safety.
At the onset of throat disease with constipation, Dahuang (Rhei Radix et Rhizoma) and Xuanmingfen (Mirabilite) should be used to purge, allowing fire to descend naturally and facilitating recovery. In fire-reducing and detoxifying formulas, remove Qianhu (Peucedani Radix) and add Dahuang and Xuanmingfen. However, if five or six days have passed without food intake and constipation persists, using these purgatives will cause immediate death. After prolonged illness, stomach qi is deficient; how can Nuxiao (Niter) and Huanglian/Dahuang be used again? Only Mi Dao Fa (Honey Suppository Method) is appropriate; this is a secret technique. Throat diseases accompanied by absence of phlegm are incurable.
Treatment requires blowing medicine four or five times through the tube to expectorate phlegm; three treatments can achieve full recovery. For initial expectoration, using more Jindan (Golden Pellet) is essential. Blow heavily directly into the throat, then immediately withdraw the tube to prevent vomiting.
In the first one or two days of throat disease, use Bidan (Green Pellet) gradually increasing Jindan. In severe cases, Jindan serves as the sovereign drug, or is used alone, to extract stubborn phlegm; expectoration requires Jindan.
If redness and swelling appear on the chest during throat disease, this indicates Feiyong (Lung Abscess). Take mixed with honey, adding Baiyaojian (Myrobalan Extract). For redness and pain in the throat without visible structural changes, blow Dengcao Hui (Ash of Junci Medulla).
For women suffering from throat swelling and pain due to amenorrhea causing fire to attack upwards, internal administration of menstruation-promoting drugs is indicated; once menstruation flows, the throat heals spontaneously.
In critical throat cases, facial swelling with a bright white luster lacking radiance, and a deep, faint, and weak pulse, indicate leakage of spirit and absence of Yang; this is absolutely incurable. Conversely, if the face is red and swollen with a surging, forceful pulse, despite severe symptoms, it indicates robust Yuanqi (Original Qi) and excess fire, which is easy to treat.
Swelling and ulceration inside the cheeks and mouth should be gently stirred with silk-wrapped chopsticks dipped in water. If painful, medication will cure it; if painless, it is necrotic tissue and difficult to treat.
For tongue swelling filling the mouth with the tongue protruding, making oral medication difficult, grind Jiangcan (Bombyx Batryticatus) and Zaojiao (Gleditsiae Sinensis Fructus) into fine powder. Mix equal parts, take a small amount, and blow into the nose. The jaw will open naturally, and saliva/phlegm will flow out. Then, use cotton-wrapped bamboo chopsticks dipped in Gancao Tang (Licorice Decoction) to moisten the lips and mouth. Add Siwei Kougan Yao (Four-Ingredient Mouth Ulcer Medicine) with extra Bingpian (Borneolum Syntheticum), blowing frequently until healing occurs.
When blowing medicine, apply not only to the swollen/ulcerated area but also to the surrounding healthy tissue to prevent spread and facilitate healing. If the tongue is extremely dry, making blowing difficult, moisten with honey or decoction before application. For intra-throat blowing, maintain calm breathing and ensure the tube reaches all areas evenly.
For tongue enlargement, apply Shenghuangbai Mo (Raw Phellodendri Cortex Powder) mixed with Bingpian. If bleeding occurs, use Chao Huangbai (Stir-fried Phellodendri Cortex) with Bingpian.
For Sheyong (Tongue Abscess) and Houyong (Throat Abscess), if stool is blocked, add Xuanmingfen and Dahuang to the formula. If urination is difficult, add Liuyisan (Six-to-One Powder); this method is very effective.
When using Bidan, if symptoms are critical, use more Bingpian than Gancao; as recovery approaches, use more Gancao than Bingpian.
For Yayong (Gum Abscess), the gum root is red and swollen, but the jaw is not locked, allowing mouth opening/closing. If Yaoyao (Lockjaw/Tetanus-like symptom) occurs, the gum root is red/swollen with protruding flesh.
For lockjaw where the mouth cannot open, first blow Jin dan and Bi dan into the gum roots. Externally, carve Huangshu Xiang (Yellow Resin) into a chisel shape and gently insert it into the tooth gap to gradually open the jaw, then blow Jindan into the affected area.
When blowing the throat or inducing expectoration, add a small amount of Zaojiao.
During initial treatment, instruct the patient to lower their head to allow saliva and phlegm to drain out.
For Houyong (Throat Abscess) and Dan/Shuang E (Single/Double Tonsillitis), generally use Bidan. For other severe conditions, combine Jindan and Bidan, noting the sequence and ratio: initially 9 parts Bidan to 1 part Jindan; after five applications, change to 8 parts Bidan to 2 parts Jindan; next, 7 parts Bidan to 3 parts Jindan. If severe, use equal parts. After 3-5 applications, if phlegm accumulates upwards, switch to 6 parts Jindan to 4 parts Bidan. Blow heavily directly into the throat and withdraw immediately to extract phlegm; this is a key technique. For extremely severe cases, using 8 parts Jindan to 2 parts Bidan is superior.
If the throat lesion has already ulcerated, first blow flesh-regenerating medicine, then treat with Bidan.
Tongjing Fang (Menstruation-Promoting Formula) (Contraindicated for pregnant women)
Danggui (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra), Guangpi (Citri Reticulatae Pericarpium), Chuanduan (Dioscoreae Nipponicae Rhizoma) (each 1 qian); Niuxi (Achyranthis Bidentatae Radix) (1.5 qian); Chuanxiong (Ligustici Chuanxiong Rhizoma) (0.6 qian); Honghua (Carthami Flos) (0.7 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 qian); Jiegeng (Platycodonis Radix) (1 qian).
Add Shengdihuang and Danpi for blood heat; add Xijiao for extreme heat. Add Sumu (Sappan Lignum), Wulingzi (Trogopteri Dung), and Zelan Ye (Lycopus Herb) for chronic obstruction. Add Yuansuoxo (Corydalis Rhizoma) and Taoren (Persicae Semen) for abdominal pain. Add Duzhong (Eucommiae Cortex) and doubled Niuxi for thigh pain.
Gao Zi Yao (Paste Medicines): Mix honey to a green-black color. Use Longnao (Camphora) and Bohe (Menthae Haplocalycis Herba) as sovereign, Yudang (Jade Pellet) as minister, Chuanbei (Fritillariae Cirrhosae Bulbus, de-hearted) as assistant, and Dengcao Hui, Baicaoshuang (Soot from Kitchen Chimney), Gancao, and Bingpian as guides. First grind Yudang and Baicaoshuang together, add Dengcao Hui and grind again, then add Bohe, Gancao, and Chuanbei, grinding to extreme fineness. Finally add Bingpian and mix uniformly. Take mixed with honey. For Houyong and Houjun (Throat Polyp/Fungus), keep in mouth and swallow frequently. If severe, take three doses internally and use blowing therapy.